| NPI | 1346536984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35138903) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2011017885) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-11-16 |